The goal of this study is to evaluate whether a standard enteral nutrition protocol can improve the efficiency in achieving nutritional goals and improve prognosis in critically ill patients.
As investigators all know, the nutrition status in critically ill patients is associated with the prognosis of these patients. And it has been confirmed that early enteral nutrition results in better outcome. However,some epidemiological investigation reported that in most intensive care unit, the phenomenon of delayed feeding or under feeding are not uncommon. In 2007, a study reported that the percentage of early enteral nutrition within 48h is 64%, based on mechanical ventilated patients in 208 intensive care unit nationally. Other study indicated that the calorie supported by the enteral nutrition only constitute 50% of the target calorie. Several studies have showed that the application of a standard enteral nutrition protocol could result in an improvement in the delivery of enteral feedings to patients. However, there is no such study in China.The goal of this study is to evaluate whether a standard enteral nutrition protocol can improve the efficiency in achieving nutritional goals and improve prognosis in critically ill patients.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
439
Patients in the experimental arm, the practice of enteral nutrition will based on a standard protocol. The core content of this protocol includes five step：1. Whether the participants need nutrition therapy? 2. The choice of nutrition way? 3. Nasogastric tube or nasointestinal tube? 4. The choice of enteral nutrition type? 5. The target calorie and protein of the participants? And how to achieve these target？(In this study, the practice of the above protocol is the only intervention).
The second affiliated hospital of Zhejiang university, school of medicine.
Hangzhou, Zhejiang, China
The proportion of patients receiving enteral nutrition in patients receiving any type of nutrition
Time frame: 7 days after ICU admission
The time from hospital admission to the begain Enteral nutrition.
Time frame: 7 days after ICU admission
The time from hospital admission to achieve the target calorie.
Time frame: 7 days after ICU admission
The proportion of patients receiving parenteral nutrition in patients receiving any type of nutrition
Time frame: 7 days after ICU admission
The proportion of patients receiving Enteral plus supplement parenteral in patients receiving any type of nutrition
Time frame: 7 days after ICU admission
ICU mortality.
Time frame: From date of the ICU admission until discharge form ICU,assessed up to 12 months
Hospital mortality.
Time frame: From date of the ICU admission until discharge form hospital,assessed up to 12 months
ICU length of stay
Time frame: From date of the ICU admission until discharge form ICU,assessed up to 12 months
Duration of mechanical ventilation.
Time frame: From date of the initiation of mechanical ventilation until weaning,assessed up to 12 months
ICU fee.
Time frame: From date of the ICU admission until discharge form ICU,assessed up to 12 months
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The incidence of complications(Diarrhea , abdominal distension, nausea and vomiting.)
Time frame: From date of the ICU admission until discharge form ICU,assessed up to 12 months